The Influence of the COVID-19 Pandemic on Intensivists’ Well-Being: A Qualitative Study

Kelly C. Vranas, Sara E. Golden, Shannon Nugent, Thomas S. Valley, Amanda Schutz, Abhijit Duggal, Kevin P. Seitz, Steven Y. Chang, Christopher G. Slatore, Donald R. Sullivan, Catherine L. Hough, Kusum S. Mathews

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The COVID-19 pandemic has strained health care systems and has resulted in widespread critical care staffing shortages, negatively impacting the quality of care delivered. Research Question: How have hospitals’ emergency responses to the pandemic influenced the well-being of frontline intensivists, and do any potential strategies exist to improve their well-being and to help preserve the critical care workforce? Study Design and Methods: We conducted semistructured interviews of intensivists at clusters of tertiary and community hospitals located in six regions across the United States between August and November 2020 using the “four S” framework of acute surge planning (ie, space, staff, stuff, and system) to organize the interview guide. We then used inductive thematic analysis to identify themes describing the influence of hospitals’ emergency responses on intensivists’ well-being. Results: Thirty-three intensivists from seven tertiary and six community hospitals participated. Intensivists reported experiencing substantial moral distress, particularly because of restricted visitor policies and their perceived negative impacts on patients, families, and staff. Intensivists also frequently reported burnout symptoms as a result of their experiences with patient death, exhaustion over the pandemic's duration, and perceived lack of support from colleagues and hospitals. We identified several potentially modifiable factors perceived to improve morale, including the proactive provision of mental health resources, establishment of formal backup schedules for physicians, and clear actions demonstrating that clinicians are valued by their institutions. Interpretation: Restrictive visitation policies contributed to moral distress as reported by intensivists, highlighting the need to reconsider the risks and benefits of these policies. We also identified several interventions as perceived by intensivists that may help to mitigate moral distress and to improve burnout as part of efforts to preserve the critical care workforce.

Original languageEnglish (US)
Pages (from-to)331-345
Number of pages15
JournalCHEST
Volume162
Issue number2
DOIs
StatePublished - Aug 2022

Keywords

  • COVID-19 pandemic
  • ICU
  • burnout syndrome
  • clinician well-being
  • moral distress
  • qualitative methods
  • visitor policies

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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